Harbor Homes wins 3-year-old court case over Medicaid funding

NASHUA – Harbor Homes should not have lost Medicaid support for mental health services, the state Supreme Court has ruled in a case that dates back in 2011.

The ruling, handed down Wednesday, concerns the complicated process by which federal Medicaid funds are used to support mental health services, and says that clients can’t be forced to avoid Harbor Homes because the state said they must go elsewhere. The state said in 2011 that clients getting Medicaid funding should be treated at Greater Nashua Mental Health Center. ...
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NASHUA – Harbor Homes should not have lost Medicaid support for mental health services, the state Supreme Court has ruled in a case that dates back in 2011.

The ruling, handed down Wednesday, concerns the complicated process by which federal Medicaid funds are used to support mental health services, and says that clients can’t be forced to avoid Harbor Homes because the state said they must go elsewhere. The state said in 2011 that clients getting Medicaid funding should be treated at Greater Nashua Mental Health Center.

“This means we’re back in the business of providing services for these clients,” said Thomas Quarles Jr., an attorney who represented Harbor Homes in the case.

He said Harbor Homes estimated that about 90 people would want to resume their mental health serves at the Nashua facility, out of the 150 the facility was treating at the time when the state said they had to shift to another provider.

“To what extent we can get back into the business, and what time frame, needs to be seen,” Quarles said. He said Harbor Homes laid off about 90 employees when the Medicaid funding was cut.

Since 1991, Harbor Homes has provided independent living and support or rehabilitative services to people with serious mental illness who are eligible for Medicaid, which offers health care for low-income individuals.

In 2008, it updated the latest in what is known as an interagency agreement with Greater Nashua Mental Health Center, which authorized Harbor Homes to provide services to some of its patients.

In 2011, Greater Nashua Center ended the interagency agreement, and the state’s Department of Health and Human Services subsequently said Harbor Homes could no longer provide Medicaid-funded services to those people.

According to Telegraph stories at the time, the transfer was triggered by a legislative budget audit and supported by a report from the staff of then-Gov. John Lynch.

Lynch’s staff argued that the mental health center was providing the same services at a cheaper cost.

Harbor Homes officials countered that their cost was greater because they were providing more extensive services than just mental health counseling.

Harbor Homes and four of its client patients sued, saying they still wanted to be treated at Harbor Homes. Their case was turned down by a Superior Court judge, and they appealed to the state Supreme Court.

The unanimous Supreme Court ruling, written by Justice Carol Ann Conboy, overturns the Superior Court judgement. It says losing the interagency agreement did not affect Harbor Homes’ “fitness to render the medical services required,” which is the standard under which the state is supposed to decide about Medicaid funding.

Conboy wrote that rejecting Harbor Homes violates the Medicaid Act’s free-choice-of-provider provision, which says individuals may “obtain such assistance from any institution, agency, community pharmacy or person qualified to perform the service or services required.”

“This says people can’t be forced to get all of their mental health services from one agency or one provider if there’s another one available,” said C. Adrienne Mallinson, an attorney for Disability Rights Center in Concord who argued the case. “The state doesn’t have total discretion saying who they get to see.”

The case has been sent back to lower court for further action.

David Brooks can be reached at 594-6531 or dbrooks@nashuatelegraph.com. Also, follow Brooks on Twitter (@GraniteGeek).